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Photorefractive Keratectomy With Mitomycin-C for Consecutive Hyperopia After Radial Keratotomy

Anbar, Roberto MD; Malta, João Baptista MD; Barbosa, José Bonifácio MD; Leoratti, Maria Cristina MD; Beer, Sandra MD; Campos, Mauro MD

doi: 10.1097/ICO.0b013e31818c4d47
Clinical Science

Purpose: To evaluate the safety, efficacy, and stability of excimer laser photorefractive keratectomy (PRK) and mitomycin-C (MMC) 0.02% for consecutive hyperopia after radial keratotomy (RK).

Methods: A prospective, nonrandomized, noncomparative interventional case series of 35 eyes (22 patients) with consecutive hyperopia after RK. All eyes were treated with PRK, using a single intraoperative topical application of MMC 0.02% for 60 seconds. Uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, slit-lamp evidence of corneal haze, and endothelial cell counts were evaluated for up to 18 months after surgery.

Results: Postoperative follow-up was 9.6 ± 5.5 months (ranged from 3 to 18 months). The mean spherical equivalent was +3.36 ± 1.94 diopters preoperatively and +0.27 ± 1.38 diopters 12 months after surgery. The uncorrected visual acuity was ≥20/30 in 37.1% of the eyes at 1 month and 78.6% of the eyes at 12 months. At 12 months, 14% of the eyes lost up to 1 line of Snellen acuity in the best spectacle-corrected visual acuity. No corneal haze was observed and the endothelial cell counts remained unchanged postoperatively (P > 0.05).

Conclusion: PRK with MMC 0.02% for consecutive hyperopia after RK seems to be a safe and effective procedure at least in the short-term period of 6 months.

From the *Vision Institute, Federal University of São Paulo, São Paulo, Brazil; and †Department of Ophthalmology, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI.

Received for publication May 2, 2008; revision received July 14, 2008; accepted August 17, 2008.

Reprints: João Baptista Malta, MD, Department of Ophthalmology, W.K. Kellogg Eye Center, University of Michigan Medical School, 1000 Wall Street, Ann Arbor, MI 48105 (e-mail:

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